Neural cue reactivity during acute abstinence predicts short-term smoking relapse
Neural cue reactivity during acute abstinence predicts short-term smoking relapse
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DOI：
10.1111/adb.12733
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发表时间：
2020-03-01
影响因子：
3.4
通讯作者：
Lerman, Caryn
中科院分区：
文献类型：
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作者：
Allenby, Cheyenne;Falcone, Mary;Lerman, Caryn
在吸烟者中，对吸烟线索的神经反应可能对急性戒烟敏感，但与戒烟相关的线索反应性在多大程度上有助于复发尚不完全清楚。本研究在75名有戒烟动机的吸烟者中解决了这个问题。参与者在两种情况下进行血氧水平依赖性（BOLD）功能磁共振成像（fMRI）：一次是在吸烟饱腹感期间，一次是在24小时戒烟后（顺序平衡）。在成像会议之后，参与者在短期（7天）戒烟尝试之前接受简短的戒烟咨询。主要的戒烟结果是生化证实的7天复发。次要的戒烟结果指标是自我报告的戒烟天数。在禁欲（与饱腹感），吸烟提示反应显着增加，只有在前扣带皮层（ACC），其他地区显示的提示（与中性）的反应没有表现出禁欲的影响，在严格的全脑分析。在急性戒烟期间（与吸烟饱腹感相比）在ACC中表现出更大的吸烟提示反应的参与者更有可能复发（OR = 2.10/信号变化百分比的标准差增加[戒烟减去吸烟饱腹感]，95% CI：1.05至4.20，P = 0.036）。戒断诱导的ACC激活变化越大，戒断总天数也越少（β =-0.63，95%CI = 0.43至0.66，P < 0.0001）。这项研究提供了第一个证据，表明在急性戒烟期间ACC中吸烟提示反应的变化可以预测吸烟复发，从而提高了我们对戒烟神经生物学的理解。
In smokers, neural responses to smoking cues can be sensitive to acute abstinence, but the degree to which abstinence-related cue reactivity contributes to relapse is not fully understood. This study addressed this question in a sample of 75 smokers who were motivated to quit smoking. Participants underwent blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) during presentation of visual smoking cues and neutral stimuli on two occasions: once during smoking satiety and once following 24-hour abstinence (order counterbalanced). Following the imaging sessions, participants received brief smoking cessation counseling prior to a short-term (7-day) quit attempt. The primary smoking cessation outcome was biochemically confirmed 7-day relapse. The secondary smoking cessation outcome measure was total number of self-reported days of abstinence. During abstinence (vs satiety), smoking cue reactivity was significantly increased only in the anterior cingulate cortex (ACC); other regions showing a cue (vs neutral) response did not exhibit an abstinence effect in the stringent whole-brain analysis. Participants who showed greater smoking cue reactivity in the ACC during acute abstinence (compared with smoking satiety) were more likely to relapse (OR = 2.10 per standard deviation increase in percent signal change [abstinence minus smoking satiety], 95% CI: 1.05 to 4.20, P = 0.036). Greater abstinence-induced change in ACC activation also predicted fewer total days abstinent (beta = -0.63, 95% CI = 0.43 to 0.66, P < 0.0001). This study provides the first evidence that changes in smoking cue reactivity in the ACC during acute abstinence predict smoking relapse, thereby improving our understanding of the neurobiology of smoking cessation.